Mental health outcomes among patients from Fangcang shelter hospitals exposed to coronavirus disease 2019: An observational cross-sectional study

A Cross-Sectional Survey on Psychological Health and Influencing Factors Among 2628 Asymptomatic and Mild COVID-19 Patients in Fangcang Shelter Hospital

Purpose

The Coronavirus disease 2019 (COVID-19) remains a global public health concern. Many people have been forced to change their lifestyles, which has led to psychological and sleep problem. This study aims to investigate the psychological health problems and factors among patients in the Fangcang Shelter Hospital (FSH) during the COVID-19 pandemic.

Patients and Methods

A Cross-Sectional survey was conducted to investigate the sleep, anxiety, depression and stress disorders of 2628 asymptomatic and mild patients treated in FSH of Zhengzhou, Henan Province, from 30 October to 6 December 2022, by scanning a WeChat two-dimensional code. Sociodemographic data and influencing factors in FSH were collected, Insomnia Severity Index (ISI), 9-item Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and Impact of Event Scale-Revised (IES-R) were administered. Descriptive statistics, t-tests or analysis of variance, Spearman or Pearson correlation analysis, and multivariate regression analysis were used to explore the relationships between different variables and their impact on psychological health indicators.

Results

The proportions of patients with insomnia, depressive disorder, anxiety, and stress disorders were 33.49%, 35.80%, 31.74%, and 43.57%, respectively. Spearman correlation analysis demonstrated that factors such as gender, higher education level, positive nucleic acid test results, longer illness duration, underlying diseases, and extended electronic device use were associated with elevated psychological distress scores. Notably, within FSH, extended exposure to light, a noisy environment, and sleep schedule management significantly impacted the prevalence of insomnia, depression, anxiety, and stress disorders (p<0.01). Multivariable binary logistic regression analysis identified higher education level, light exposure, noisy environment, sleep management, and electronic device usage as the primary risk factors for psychological distress.

Conclusion

Patients in FSH face psychological distress influenced by sociodemographic factors, environment, and lifestyle, highlighting the need for integrated psychological support in healthcare, particularly in temporary medical facilities during crises.

Prevalence of depression, anxiety in China during the COVID-19 pandemic: an updated systematic review and meta-analysis

Background

Mental health risks associated with the aftermath of the COVID-19 pandemic are often overlooked by the public. The aim of this study was to investigate the effects of the COVID-19 pandemic on depression and anxiety disorders in China.

Methods

Studies were analyzed and extracted in accordance with the PRISMA 2020 flowchart. The studies were screened and extracted using electronic databases including PubMed, Web of Science, Embase, Cochrane Library, and ClinicalTrials.gov according to the predefined eligibility criteria. The Cochrane Review Manager software 5.3.1 was used for data analysis and the risk of bias assessment.

Results

As of 2023, a total of 9,212,751 Chinese have been diagnosed with COVID-19 infection. A total of 913,036 participants in 44 studies were selected following the eligibility criteria, the statistical information of which was collected for meta-analysis. The pooled prevalence of depression and anxiety were 0.31 (95% CI: 0.28, 0.35; I2 = 100.0%, p < 0.001) and 0.29 (95% CI: 0.23, 0.36; I2 = 100.0%, p < 0.001), respectively. After performing a subgroup analysis, the prevalence of depression among women, healthcare workers, students, and adolescents was 0.31 (95% CI: 0.22, 0.41), 0.33 (95% CI: 0.26, 0.44), 0.32 (95% CI: 0.26, 0.39), and 0.37 (95% CI: 0.31, 0.44), respectively.

Conclusion

The prevalence of depression and anxiety among the Chinese was overall high. Monitoring and surveillance of the mental health status of the population during crises such as sudden global pandemics are imperative.

Systematic review registration

https://clinicaltrials.gov/, identifier [CRD42023402190].

Effect of Sleep Duration on Blood Pressure in Patients with SARS-CoV-2 Infection and Hypertensive Urgencies in Shanghai Fangcang Shelter Hospital

Objective

To evaluate the effect of sleep duration on blood pressure in patients with hypertension urgencies combined with SARS-CoV-2 infection in a Fangcang shelter hospital.

Methods

From April 10, 2020 to May 20, 2022, we statistically analyzed the blood pressure and sleep conditions of 52 patients with combined hypertension urgencies and SARS-CoV-2 infection admitted in Shanghai National Convention and Exhibition Center Fangcang shelter hospital. They were divided into the short-term (daily sleep duration: <7 h) and normal sleep group (7-9 h). We performed a comparison of the control effects of basic antihypertensive drugs. Additionally, patients in the short-term sleep group underwent drug therapy for sleep regulation and continuous monitoring of blood pressure.

Results

Among these patients, the blood pressure was higher in the short-term sleep group than that of the normal sleep group, and also more difficult to control (p <0.05). Furthermore, the blood pressure of the patients in the short-term sleep group was more easily controlled after treatment with drugs for sleep regulation and basic antihypertensive drugs (p <0.05).

Conclusion

The blood pressure level in patients with combined SARS-CoV-2 infection and hypertension urgencies was higher in those with a shorter duration of daily sleep, and also more difficult to control in Fangcang shelter hospital. Drug therapy for sleep regulation should be administered early to obtain sufficient blood pressure control effects.

Medical implementation practice and its medical performance evaluation of a giant makeshift hospital during the COVID-19 pandemic: An innovative model response to a public health emergency in Shanghai, China

Introduction

In confronting the sudden COVID-19 epidemic, China and other countries have been under great pressure to block virus transmission and reduce fatalities. Converting large-scale public venues into makeshift hospitals is a popular response. This addresses the outbreak and can maintain smooth operation of a country or region's healthcare system during a pandemic. However, large makeshift hospitals, such as the Shanghai New International Expo Center (SNIEC) makeshift hospital, which was one of the largest makeshift hospitals in the world, face two major problems: Effective and precise transfer of patients and heterogeneity of the medical care teams.

Methods

To solve these problems, this study presents the medical practices of the SNIEC makeshift hospital in Shanghai, China. The experiences include constructing two groups, developing a medical management protocol, implementing a multi-dimensional management mode to screen patients, transferring them effectively, and achieving homogeneous quality of medical care. To evaluate the medical practice performance of the SNIEC makeshift hospital, 41,941 infected patients were retrospectively reviewed from March 31 to May 23, 2022. Multivariate logistic regression method and a tree-augmented naive (TAN) Bayesian network mode were used.

Results

We identified that the three most important variables were chronic disease, age, and type of cabin, with importance values of 0.63, 0.15, and 0.11, respectively. The constructed TAN Bayesian network model had good predictive values; the overall correct rates of the model-training dataset partition and test dataset partition were 99.19 and 99.05%, respectively, and the respective values for the area under the receiver operating characteristic curve were 0.939 and 0.957.

Conclusion

The medical practice in the SNIEC makeshift hospital was implemented well, had good medical care performance, and could be copied worldwide as a practical intervention to fight the epidemic in China and other developing countries.

Evaluation of the prevalence of illness anxiety disorder following the COVID-19 pandemic in Iran and its related factors: a cross-sectional study

BACKGROUND AND AIMS

COVID-19 pandemic has generated a rise in psychological distress, such as illness anxiety disorder, apart from its negative physical effects. This study intends to the evaluation of illness anxiety disorder rate following the prevalence of COVID-19 in Iran and its associated factors.

METHODS

In this study, 634 people were studied. The data collection method was performed via the virtual networks using a questionnaire, with the sampling method being convenient and nonprobable with the method of snowball. Evans illness anxiety disorder questionnaire was utilized in this investigation. The logistic regression model and the χ 2 were used to evaluate the data.

RESULTS

The prevalence of illness anxiety disorder was 12.1%. The chance to have an illness anxiety disorder in the people whose relatives had a history of COVID-19 was 5.32 times, and in those who had a relative with a history of COVID-19 had higher (odds ratio = 1.27). But, this connection in people who worked or studied in nonmedical fields, is several times more than those who are busy in the medical fields. In individuals of 30 years and older, the chance of patients in single people compared to married people was 5.20 times higher, but under the age of 30 years, the chance of illness anxiety disorder in single people was 0.91.

CONCLUSION

COVID-19 pandemic, also to the physical effects, may have psychological implications for people. Therefore, reducing the individual and social activities in terms of this disease, along with measures related to physical problems, diagnosis, timely treatment and proper psychological consequences, including illness anxiety disorder can be very fruitful.

Effects of dysfunctional beliefs about sleep on sleep quality and mental health among patients with COVID-19 treated in Fangcang shelter hospitals

Introduction

With the COVID-19 pandemic in China, a large number of mild or ordinary confirmed cases have been sent to Fangcang shelter hospitals for treatment. We aimed to investigate the mental health condition of Fangcang patients 2 years after the pandemic when patients knew more about COVID-19 and the virus was less virulent. We focused on the effect of dysfunctional beliefs and attitudes about sleep on depression, anxiety, and insomnia.

Methods

A total of 1,014 patients from two large Fangcang shelter hospitals in Shanghai between 22 April and 8 May 2022 completed a set of questionnaires comprising: the Dysfunctional Beliefs and Attitudes about Sleep scale, the Generalized Anxiety Disorder scale, the Patient Health Questionnaire, and the Insomnia Severity Index scale.

Results

Results show that the positive screening rates for anxiety, depression, and insomnia among tested patients were 55.3, 27.0, and 47.8%, respectively. Patients were more likely to report higher anxiety, depression, and insomnia, and to endorse affective and sleep disorders if they were: female, aged 18-40 years, with undergraduate course or above, white-collar employees, or those who thought the pandemic would have severe economic effects. About 51.4% of the participants had dysfunctional beliefs about sleep to varying degrees. Compared with patients who had accurate beliefs about sleep, the ratios of insomnia, anxiety, and depression were significantly higher among patients with dysfunctional beliefs about sleep.

Discussion

Attention should be paid to the mental health problems of patients in Fangcang shelter hospitals. The results indicate that dysfunctional beliefs about sleep significantly increased anxiety, depression, and insomnia of Fangcang patients.

Risk factor analysis of omicron patients with mental health problems in the Fangcang shelter hospital based on psychiatric drug intervention during the COVID-19 pandemic in Shanghai, China

BACKGROUNDS

The widespread coronavirus disease 2019 (COVID-19) outbreak impacted the mental health of infected patients admitted to Fangcang shelter hospital a large-scale, temporary structure converted from existing public venues to isolate patients with mild or moderate symptoms of COVID-19 infection.

OBJECTIVE

This study aimed to investigate the risk factors of the infected patients from a new pharmacological perspective based on psychiatric drug consumption rather than questionnaires for the first time.

METHODS

We summarised the medical information and analysed the prevalence proportion, characteristics, and the related risk factors of omicron variants infected patients in the Fangcang Shelter Hospital of the National Exhibition and Convention Center (Shanghai) from 9 April 2022 to 31 May 2022.

RESULTS

In this study, 6,218 individuals at 3.57% of all admitted patients in the Fangcang shelter were collected suffering from mental health problems in severe conditions including schizophrenia, depression, insomnia, and anxiety who needed psychiatric drug intervention. In the group, 97.44% experienced their first prescription of psychiatric drugs and had no diagnosed historical psychiatric diseases. Further analysis indicated that female sex, no vaccination, older age, longer hospitalization time, and more comorbidities were independent risk factors for the drug-intervened patients.

CONCLUSION

This is the first study to analyse the mental health problems of omicron variants infected patients hospitalised in Fangcang shelter hospitals. The research demonstrated the necessity of potential mental and psychological service development in Fangcang shelters during the COVID-19 pandemic and other public emergency responses.

The machine learning model based on trajectory analysis of ribonucleic acid test results predicts the necessity of quarantine in recurrently positive patients with SARS-CoV-2 infection

Background

SARS-CoV-2 patients re-experiencing positive nucleic acid test results after recovery is a concerning phenomenon. Current pandemic prevention strategy demands the quarantine of all recurrently positive patients. This study provided evidence on whether quarantine is required in those patients, and predictive algorithms to detect subjects with infectious possibility.

Methods

This observational study recruited recurrently positive patients who were admitted to our shelter hospital between May 12 and June 10, 2022. The demographic and epidemiologic data was collected, and nucleic acid tests were performed daily. virus isolation was done in randomly selected cases. The group-based trajectory model was developed based on the cycle threshold (Ct) value variations. Machine learning models were validated for prediction accuracy.

Results

Among the 494 subjects, 72.04% were asymptomatic, and 23.08% had a Ct value under 30 at recurrence. Two trajectories were identified with either rapid (92.24%) or delayed (7.76%) recovery of Ct values. The latter had significantly higher incidence of comorbidities; lower Ct value at recurrence; more persistent cough; and more frequently reported close contacts infection compared with those recovered rapidly. However, negative virus isolation was reported in all selected samples. Our predictive model can efficiently discriminate those with delayed Ct value recovery and infectious potentials.

Conclusion

Quarantine seems to be unnecessary for the majority of re-positive patients who may have low transmission risks. Our predictive algorithm can screen out the suspiciously infectious individuals for quarantine. These findings may assist the enaction of SARS-CoV-2 pandemic prevention strategies regarding recurrently positive patients in the future.

The Association between Resilience and Psychological Distress during the COVID-19 Pandemic: A Systematic Review and Meta-Analysis

This study examined the association between resilience and psychological distress in healthcare workers, the general population, and patients during the COVID-19 pandemic. We searched the PubMed, Web of Science, PsycInfo, Science Direct, and Nursing and Allied Health databases. Included articles examined healthcare workers (e.g., physicians and nurses), the general population, and patients during the COVID-19 pandemic. Studies of exposure to other infectious diseases related to epidemics or pandemics (e.g., SARS and MERS) were excluded. This study was performed following the Cooper matrix review method and PRISMA guidelines, followed by a meta-analysis of study results using R version 4.1.2. A random effect model was used for the pooled analysis. This study was registered with PROSPERO (registration No. CRD42021261429). Based on the meta-analysis, we found a moderate negative relationship between overall resilience and psychological distress (r = -0.42, 95% confidence interval [CI]: -0.45 to -0.38, p < 0.001). For the subgroup analysis, a moderately significant negative relationship between overall resilience and psychological distress was found among healthcare workers (r = -0.39, 95% CI: -0.44 to -0.33, p < 0.001), which was weaker than in the general population (r = -0.45, 95% CI: -0.50 to -0.39, p < 0.001) and in patients (r = -0.43; 95% CI: -0.52 to -0.33; p < 0.001). This association was robust, although the heterogeneity among individual effect sizes was substantial (I² = 94%, 99%, and 74%, respectively). This study revealed a moderate negative relationship between resilience and psychological distress in healthcare workers, the general population, and patients. For all these populations, interventions and resources are needed to improve individuals' resilience and ability to cope with psychological distress during the COVID-19 pandemic and in future disease outbreaks.

Experiences of COVID-19 patients in a Fangcang shelter hospital in China during the first wave of the COVID-19 pandemic: a qualitative descriptive study

OBJECTIVES

This study aimed to examine COVID-19 patients' experiences in a Fangcang shelter hospital in China, to provide insights into the effectiveness of this centralised isolation strategy as a novel solution to patient management during emerging infectious disease outbreaks.

DESIGN

This study adopted a qualitative descriptive design. Data were collected by individual semistructured interviews and analysed using thematic analysis.

SETTING

This study was undertaken in 1 of the 16 Fangcang shelter hospitals in Wuhan, China between 28 February 2020 and 7 March 2020. Fangcang shelter hospitals were temporary healthcare facilities intended for large-scale centralised isolation, treatment and disease monitoring of mild-to-moderate COVID-19 cases. These hospitals were an essential component of China's response to the first wave of the COVID-19 pandemic.

PARTICIPANTS

A total of 27 COVID-19 patients were recruited by purposive sampling. Eligible participants were (1) COVID-19 patients; (2) above 18 years of age and (3) able to communicate effectively. Exclusion criteria were (1) being clinically or emotionally unstable and (2) experiencing communication difficulties.

RESULTS

Three themes and nine subthemes were identified. First, COVID-19 patients experienced a range of psychological reactions during hospitalisation, including fear, uncertainty, helplessness and concerns. Second, there were positive and negative experiences associated with communal living. While COVID-19 patients' evaluation of essential services in the hospital was overall positive, privacy and hygiene issues were highlighted as stressors during their hospital stay. Third, positive peer support and a trusting patient-healthcare professional relationship served as a birthplace for resilience, trust and gratitude in COVID-19 patients.

CONCLUSIONS

Our findings suggest that, while sacrificing privacy, centralised isolation has the potential to mitigate negative psychological impacts of social isolation in COVID-19 patients by promoting meaningful peer connections, companionship and support within the shared living space. To our knowledge, this is the first study bringing patients' perspectives into healthcare service appraisal in emergency shelter hospitals.